Impact of two types of sodium and ultra filtration profiles on Intradialytic hypotension in hemodialysis patients

Abstract

BACKGROUND: Intradialytic hypotension is the most common complication of haemodialysis (HD) and the main cause for patient's dissatisfaction. One of the new preventive methods for it is the use of sodium profile and ultrafiltration (UF) profile. This study was designed to evaluate the effect of two types of sodium and UF profile on intradialytic hypotension.

METHODS: In this cross-sectional study, 26 stable HD patients from two dialysis center in Isfahan city, underwent three treatments in 3 dialysis sessions: 1. control, constant dialysate sodium concentration of 138 mmol/l with constant UF; 2. linear sodium profile + UF profile (type 1), a linearly decreasing dialysate sodium concentration (138-146 mmol/l) combination with a linearly decreasing UF rate; and 3. stepwise sodium profile + UF profile (type 2), a stepwise decreasing dialysate sodium concentration (138-146 mmol/l) combination with a stepwise decreasing UF rate. Data were analyzed via SPSS-14 by using χ2 test.

RESULTS: In this study a total of 26 patients were participated with the mean age of 46.8 ± 19 years. In each group, 78 dialysis sessions and a total of 234 dialysis sessions were analyzed. The incidence of intradialytic hypotension wassignificantly reduced during two type of profiles compared with control (p < 0.05). But there was no significant difference between profiles (p > 0.05).

DISCUSSION: Sodium and UF profile is simple and cost effective methods that modulates the dialysate sodium and ultrafiltration rate, and preserve the homodynamic status of patients during dialysis. This method can reduce the incidence of intradialytic hypotension.

KEY WORDS: Intradialytic hypotension (IHD), sodium profile, ultrafiltration profile, hemodialysis patients (HD).